Florida Governor Race. Scott Wins. Keep your eye on PIP.

Florida Governor Race.  Scott Wins.  Keep your eye on PIP.

Dr. Alan Himmel


Well, not much to say about the results of the Florida Governor race. For the sake of Florida drivers and doctors who treat accident patients, lets hope that we have another four years of PIP.

The fact that Rick Scott was the former CEO of a gigantic hospital company may be of benefit.  He likely still has ties to that company, whether it be his buddies who are in favor of first party PIP coverage for accident victims, or he still has his hands directly in the pot; he most likely is not in favor of a total elimination of PIP.

It just bothers me that a man who plead the 5th in an investigation of his company, can still be the governor of a state.  If a person is put on the stand and pleads the 5th, it simply tells you they are hiding information which will be incriminating.  Note the breakdown of the word inCRIMINating.

Ok, so he is a crook and got away with it.  He is not the first person to commit crimes and get away with it and he wont be the last.  But, become governor twice after this?  Amazing, but I wish I could say I am surprised.

What Does it Mean when they say PIP is Primary?

What Does it Mean when they say PIP is Primary?

Dr. Alan Himmel

PIP No-Fault Insurance is primary in Florida.  What this means is, if you are involved in a car accident in the State of Florida, and you either have your own car with insurance or are living with a resident relative (living in a house with family member who has a car with insurance) you are required by law to have all claims for injuries filed through PIP.  PIP is primary, meaning that even if you have your own health insurance, Medicare, Medicaid, or group plan, you have no choice but to use PIP first.

Most doctors who treat trauma/accident patients know this, unless they are new and have not been trained or have no experience with these types of patients.

So, what happens if you go see a doctor after a car accident, and hand them your health insurance card?  Well, if the doctor bills health insurance instead of PIP, there is actually a chance that the bill will get paid.  Why?  Because at this point, the insurance company is unaware of the fact that the patient is being treated for a car accident.  They process they claim as they do any other claim.

But, this is what I have seen over and over again over the years.  After a few weeks or months, the health insurance company will send a letter out to the policyholder and ask him a few questions, the most important one being describe the circumstances that led to your injury, and were you in a vehicle at the time of your injury?

If, through these questions, the insurance company learns that the patient was indeed in a car accident, the insurance company will usually proceed in one of two ways:  First, they can ask for the money back from the doctor.  Or second, they can wait to see if there is a legal settlement which will be paid out to the patient, and if so, they can put a lien on the settlement in order to be paid back.

If you have health insurance, you can use it for claims that are over and above the PIP payable amount (Secondary, not Primary). In other words, since PIP mainly pays 80% of the claim, health insurance can pick up the 20%.  You can also submit deductibles to them, and you can submit all claims to health insurance that exceed the $2500 or $10,000 in coverage.  If PIP denies the claim completely for reasons of failure to pay policy premium, or failure to carry, or anything, then health insurance can be billed in these circumstances.  But, remember, if you have a settlement pending that is due to this accident, you will pay the insurance company back from your settlement.

If you are one of those patients who just does not want to use your PIP car insurance for one reason or another, you will find yourself in one of the two scenarios up above.  Chances are, your health insurance will request the money back from the doctor or you will have to pay it out of any settlement you receive.

I have been treating car accident patients since 1996.

Consult with me for injuries relating to car accidents. I can be reached directly at 954-659-8600. Always consult with an attorney with issues regarding the law.  I am not an attorney.

My office address is:

Alan Himmel, DC, PA.
3161 Dykes Road
Miramar, FL.  33027

FL EMERGENCY MEDICAL CONDITION PIP DENIALS BEGIN

FL EMERGENCY MEDICAL CONDITION PIP DENIALS BEGIN

Dr. Alan Himmel

Just as predicted, there are some companies who are ignoring Emergency Medical Conditions and denying PIP coverage beyond $2500.   So, a medical provider, in many cases a specialist, will look at and examine a patient, and say, "Yes, without medical treatment, this patient is likely going to suffer long term permanent impairments,"  and write it exactly as the law is written, and certain insurance companies are having the doctor's notes and records reviewed by one of their doctors to say that its not true.

I just had a patient with an shoulder impingement syndrome denied.  The patient cannot raise her arm up past 90 degrees in any direction.  She cannot take a half gallon of milk out of the fridge due to pain and weakness in her shoulder, and an insurance company doctor says she needs no further treatment. The MRI alone was more than half her PIP benefit.

Surprisingly, this denial is happening with major providers.  You would think that the small rip-off companies would be doing this, but as I said, even the big boys are doing it.

So, what do you do?  As a doctor who spends a lot of time with patients one on one (sometimes more than an hour), I have to make a decision.  The decision is whether to release the patient from care, or to continue treating in the hopes that in the end, a suit can be filed, and the insurance company will eventually pay.  SInce this whole EMC thing is a new thing in Florida, there are a lot of unknowns.

The first unknown is whether a suit can be won in the first place.  Lawyers cannot guarantee a win. And, as I said, this is a new program in FL, so there is not a whole lot of new case law.   Secondly, if a suit is won, will the WHOLE bill be paid, or will only part of it be paid?  What if a Judge says, pay the bill, but only 20% of it?  Can they do that?  A colleague of mine seems to think so.  He may be right.

My patient with shoulder impingement I am continuing to see and treat.  She is doing better and better. Without treatment her condition would likely turn into frozen shoulder.

Lets Get Rid of BI and UM Coverage in Florida.

Lets Get Rid of BI and UM Coverage in Florida.

Dr. Alan Himmel

I love it when a lawyer comes out and says to get rid of PIP.  Sure, Mr. "For the People,"  lets do that. Lets throw the baby out with the bathwater.


http://www.wctv.tv/news/floridanews/headlines/Attorney-Says-Auto-Insurance-Changes-Will-Be-Costly-218003841.html


Why should all the legit people and doctors be penalized for the dirtbags in this state?  This mentality makes no sense to me.  Mr. For the People would like to see PIP go away and instead make BI mandatory.  This sounds good as long as you are a PI lawyer.  As long as HIS livelihood isn't affected its good for HIM. Well I have a family to support and bills to pay.  I don't go on fancy vacations, drive a fancy car, or have my own airplane.  I am just trying to survive.  When I read this from this guy, it just infuriates me.  Maybe he should change his slogan to "For Me."


Crack down on the fraud.  Get the bad people out.   That's the solution.

PIP Injunction. Affidavit and/or Donations Needed Now! Florida PIP Defense Fund.

PIP Injunction. Affidavit and/or Donations Needed Now!  Florida PIP Defense Fund.

Help Save Florida PIP

Dr. Alan Himmel

As you are aware by now, the Mr. Lirot and Mr. Levine have been fighting to keep the Florida No-Fault Law in place for Florida residents and providers.  click:  FLORIDA PIP DEFENSE  They need these affidavits filled out and sent in.  They also need money.  But, if you cant send money, you can at least file an affidavit explaining how the changes in PIP will affect your livelihood.  Below are the Affidavits. There are instructions below as well, including where to send your donation and affidavit.

Below is the affidavit for Florida Providers: Print this form out. Follow the instructions (below) on how to fill it out properly and where to mail it. Here is the link to the PDF: 

Click here for the Affidavit if you are a Florida Provider

UNITED STATES DISTRICT COURT

MIDDLE DISTRICT OF FLORIDA

TAMPA DIVISION

ROBIN A. MYERS, A.P., an individual
person and Acupuncture Physician,

GREGORY S. ZWIRN, D.C., an individual
persona and Chiropractic Physician,

SHERRY L. SMITH, L.M.T., an individual
person and Licensed Massage Therapist, Case No. 8:12-cv-2660-T-26TBM

CARRIE C. DAMASKA, L.M.T., an individual
person and Licensed Massage Therapist,

“JOHN DOE,” on behalf of all similary
situated health care providers,

“JANE DOE,” on behalf of all those injured
by motor vehicle collisions,

Plaintiffs,

v.

KEVIN N. McCARTY, in his Official Capacity as
Commissioner of the Florida Office of Insurance
Regulation,

Defendant.
__________________________________________/

AFFIDAVIT OF  ______________[INSERT YOUR NAME HERE]_______________

STATE OF FLORIDA )
COUNTY OF [FILL IN COUNTY] )

Before me, the undersigned authority, appeared    [YOUR NAME HERE], having been duly identified and who states under oath the following:

1. I am over the age of 18 years and otherwise competent to make this affidavit;
2. I have personal knowledge of the facts set forth herein;
3. I am a resident of  [FILL IN COUNTY] County;
4. I am a [INSERT TYPE OF HEALTH CARE PROVIDER OR PATIENT];
5. I own [OR WORK IN OR WHATEVER - INSERT THE BUSINESS NAME];
6. My business is located in [INSERT COUNTY HERE] County;
7. I possess license number [INSERT LICENSE NUMBER HERE] issued by the State of Florida to practice [INSERT TYPE OF LICENSE HERE];
8. I read the 2012 Motor Vehicle Personal Injury Protection Insurance Act;
9. Although I [UNDERSTAND, AM CONFUSED BY ETC.] the aforementioned Act, I believe that the Act will [what you think the Act will do in your own words. Generally injunctions are granted for things that will cause you irreparable harm – i.e. even if they could give you money, you would still be harmed because your business was destroyed etc.  With an injunction, you are asking the Court to provide you with an extraordinary remedy – something that will potentially cause you such harm that you will be permanently damaged.];
10. At this time, this Act has already  [what was the impact of the act on your business?];
11. Further, I have the following comments:
12. I am requesting that this Court maintain the status quo so that I am not irreparably harmed until the Court can proceed with a full hearing or trial regarding this matter.

FURTHER AFFIANT SAYETH NAUGHT.
_______________________________________________
[INSERT YOUR NAME AND SIGN ABOVE]

NOTARY ACKNOWLEDGMENT

The foregoing Affidavit was sworn and acknowledged before me on this ___th day of _____________________ 2012 by  [INSERT NAME HERE], ___who is personally known to me, or ___ who produced the following identification: __________________________________________.

Notary signature: ________________________________
Notary name: ________________________________
Notary Expiration Date: ____________________________
Notary Seal:

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Below is the Affidavit of you are a Florida Consumer: Copy and print this form out. Follow the instructions on where to mail it. Here is the link to the PDF:  

Click here for the Affidavit if you are a Florida Consumer

IN THE CIRCUIT COURT OF THE SECOND JUDICIAL CIRCUIT

IN AND FOR LEON COUNTY, STATE OF FLORIDA

CIVIL DIVISION

ROBIN A. MYERS, A.P., an individual person 

and Acupuncture Physician, GREGORY S. 

ZWIRN, D.C., an individual person and

Chiropractic Physician, SHERRY L . SMITH, L.M.T.,

an individual person and Licensed Massage Therapist,

CARRIE C. DAMASKA, L.M.T., an individual 

person and Licensed Massage Therapist, “John Doe,”

on behalf of all similarly situated health care providers, 

and “Jane Doe,” on behalf of all those individuals 

injured by motor vehicle collisions,

Plaintiffs,

Case: 2013-CA-000073

v.

KEVIN N. McCARTY, in his Official Capacity as

Commissioner of the Florida Office of Insurance 

Regulation,

Defendant.

_____________________________________________/

AFFIDAVIT OF: ___________________________________

STATE OF FLORIDA

COUNTY OF _____________________

Before me, the undersigned authority, appeared ______________________________, having 

been duly identified and who states under oath the following:

1. I am over the age of 18 years and otherwise competent to make this affidavit;

2. I have personal knowledge of the facts set forth herein;

3. I am a resident of ______________ County;

4. I am a resident of Florida that owns a motor vehicle and is required to purchase 

$10,000.00 (ten thousand dollars) in Personal Injury Protection Insurance. My address:

_____________________________________________________________________.

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Here are the instructions to fill out the Affidavits and here is the PDF:

Click Here to view the Affidavit Instructions in PDF

AFFIDAVIT INSTRUCTIONS: 1. Tell the truth. 2. Add your name to the title: Affidavit of: Your Name. 3. Add your current County 4. Add your name to the first line, Before me…. 5. Fill in line #4 with your county of residence (where you live) 6. Fill in line #4 with your licensure: DC, LMT, AP, Consumer 7. Fill in line #5 with your business name 8. Fill in line #6 with the county your business is located in. 9. Fill in lines #7 and #8 with the impact of the 2012 PIP Act on you and your business – be as detailed as possible. An injunction is an extraordinary remedy – it is hard to get. We have to show that you and your business are being irreparably harmed – irreparable harms occur when you cannot receive mere money to make things right – things like loss of referrals, loss of patient relationship etc. Also list financial harms – all of them. 10. Fill in #10 – the state alleged that eliminating acupuncture and massage were ok because they are of no benefit. 11. Fill in #12 with any statement you wish to make. 12. If you have any accident victims that were injured before or after 1/1/13 and have been limited in their coverage, please have them fill out an affidavit too and discuss how they have been impacted by this Act. INSTRUCCIONES EN COMO LLENAR EL AFIDAVIT: (Favor de Leer todo, antes de llenar el Affidávit.) 1. Diga la verdad. 2. Agregue su nombre al título: Declaración Jurada de: Su Nombre. 3. Añada su condado actual 4. Añade tu nombre a la primera línea, delante de mí .... 5. Introduzca la línea # 4 con su condado de residencia (donde vive) 6. Introduzca la línea # 4 con su licencia: DC, LMT, AP, Consumer 7. Introduzca la línea # 5 con su nombre comercial 8. Introduzca la línea # 6 con el condado de su negocio se encuentra en 9. Llene las líneas # 7 y # 8 con el impacto de la Ley de 2012 sobre PIP de usted y su negocio - sea lo más detallado posible. Una orden judicial es un recurso extraordinario - es difícil de conseguir. Tenemos que demostrar que usted y su negocio se están irreparablemente dañados - daños irreparables ocurren cuando no se puede recibir dinero solo hacer las cosas bien - cosas como la pérdida de referencias, la pérdida de la relación médico-paciente, etc. también una lista de los daños financieros - todos ellos. 10. Rellene # 10 - el Estado alega que eliminando la acupuntura y el masaje esta bien porque ellos no son beneficiosos al accidentado. 11. Rellene # 12 con cualquier declaración que usted desea hacer. 12. Si tiene alguna víctimas de accidentes que resultaron heridos antes o después de 1/1/13 y se han limitado en su cobertura, por favor haga que llenar una declaración jurada también y discutir la forma en que se han visto afectadas por esta ley.

Elimination (REPEAL) of PIP No-Fault Insurance in Florida.

The truth about the elimination (repeal) of PIP insurance in the State of Florida.  Is it a money saver or not?  What is it really about?

Dr. Alan Himmel

First, let me refer you back to an article that I cited a few days ago regarding the cost of No-Fault in the US.

States with the lowest no Fault Premiums

You can look at the chart in the article and look at the top 10 states that for insurance premiums.  I am sure you can find a complete list of all 50 states somewhere on the net.  It's important for everyone to be aware that first and foremost, Florida does not rank even in the top 10 for high insurance cost.  In fact, according to Insure.com, Florida ranks 34th in terms of cost.  This means that there are 33 states with higher insurance rates than Florida.  And, guess what?  The number one state for high cost of insurance is Louisiana, which ironically is not even a No-Fault State.    Louisiana is a state that requires you to sue to get your medical bills paid.  When people are injured as a result of an accident, the person must SUE to get his medical bills paid.  Claims will go before a judge, where if the plaintiff wins, the doctors get paid, the lawyers get paid and of course the injured person gets paid a settlement for pain suffering and injuries.

Is this a good thing?  Well we already established that states that have no first party PIP coverage do not necessarily have lower car insurance costs.  The insurance companies are always citing Colorado as a state that dropped no-fault and premiums went down.  This may be true, buts its also just one state.   It is one single state and probably multiple reasons that this happened.  According to Insure.com, however, the elimination of No-Fault does not guarantee lower rates.  They have the numbers.  I would believe their statistics rather than the information that insurance companies will tell you or politicians who are funded by insurance companies.

If you have not thought much about it, let me lay out a few things that will happen if and when they drop no-fault in Florida.  Of course, lets not forget that Florida ranks NUMBER 2 for the most UNinsured people in the US.  There is only one state that has more uninsured people in the US and that's Texas.  Okay, so you eliminate PIP, which covers hospital emergency care, therapy, diagnostic testing, physical therapy, and chiropractic care.  You now have a situation where medical care is expensive and people are going to have to make a choice between paying their electric bill and getting proper medical treatment for injuries.  If they do decide to get medical care, they will have to SUE to get the bills paid, which means expensive court  time and potentially even larger payouts by insurance companies.

The lost wage benefit will be eliminated if PIP is eliminated.  People who are injured and cannot work are entitled to lost wage coverage under the current No-Fault system.  That will be gone.  People will have to sue for this also.

How about folks that are injured and there is no person to sue?  What if YOU crash into someone and hurt yourself?  Who is going to pay your medical bills (and lost wages) if you are at fault?  You can't sue yourself.  So, these people also, will have no medical care for injuries.  If this person goes to the hospital and has a large medical bill,and he has no insurance or no recourse against an at fault driver, then he gets stuck with a bill that he cannot pay.  He will first be put in collections, his credit will suffer, and eventually he may file bankruptcy.  This sounds like good stuff, huh?

What about children who are in a vehicle and are injured?  They will have to go through the same nightmare, if the at fault driver is the child's parent.  No insurance.  No medical treatment.  If the parent chooses medical care, they will likely never pay the bill.

So, there is something fishy going on here.  Notice Rick Scott at first did not push to eliminate PIP last year.  He purposely made sure that the hospitals (we know his affiliation with the hospitals) were taken care of.  They are practically automatically entitled to the full $10,000 if a patient comes in due to an emergency.  Insurance companies will have a hard time fighting the $10k, if a person presents to an emergency room, if the doctor at the ER states the patient is suffering an emergency medical condition.

So, is it about the money?  What is it?  What do you think is likely to happen in Florida?  Another tweak of PIP or the total elimination?

14 day Deadline to get treatment after a Car Accident Begins in Florida. Patients and Doctors are OUTRAGED!

ATTENTION CAR ACCIDENT PATIENTS!

NEW FLORIDA LAW REGARDING CAR ACCIDENT CLAIMS IN FLORIDA!

You have only 14 days to get treatment if you have been involved in a Car Accident in Florida.

Do you know what this means? This means if you are in an accident, and think that the pain will go away by itself, but it doesn't after 14 days, your insurance company that you pay all that money to every month, will DENY your claim.

Don't wait! Call Now.  954-659-8600.  Dr. A. Himmel

 14 Day Emergency Treatment offered to Car Accident Patients in Florida.

We have doctors who will see you 24 hours a day and 7 days a week at your home or our offices in Broward, Dade, or Palm Beach Counties.



If you wait one extra minute over 14 days, you lose $10,000 in PIP benefits that your are paying for by law.

CALL NOW.  This is no joke.  You will be forfeiting $10,000 of your insurance benefit if you wait.  

We have doctors who will travel to YOU so that you can initiate your treatment before the 14 day deadline expires.  We file ALL the paperwork for you so that the ONLY thing you need to worry about is feeling better after your car accident!  Any questions, just call us at 954-659-8600.  Dr. A.  Himmel

Florida No Fault 14 Day Treatment Rule.

SUPPOSE YOU HAVE A CAR ACCIDENT ON JAN 1, 2013 OR LATER...

Dr. Alan Himmel

Is anyone aware of another little change to the Florida No-Fault PIP law that goes into effect on Jan 1, 2013?  Of course not, so I am here to inform you of another very important fact that you should know if you are an insured Florida resident.

Let me set the scene: You are either the victim of or an at fault driver involved in an auto accident which occurs on, lets say Jan 1, 2013 or thereafter.  You are driving, and all of a sudden, you collide with another car which is not stopping.  The accident causes car causing damage, and also caused some neck pain and headache.  You go home that day and you take some Ibuprofen and ice it, and your neck and headache feel a little better.  You decide that the pain is not so bad, and  you figure that the neck stiffness that is setting in, is no big deal.  After all, you have had a stiff neck in the past, and it always goes away within a week or so.  So, you just decide to rest it, ice it, and take over the counter pain killers. It actually begins to feel better after about a week, and at this point you figure it will continue improving.  You are busy at work and with the family.  You don't have time to waste going to doctors and getting xrays, because you think that you will be OK, and its not that important anyway.  But it starts to get to a point that the neck pain and stiffness are not improving anymore and your wife is telling you to go get checked out.  So, you make an appointment at your doctors office.  Today is Friday and your doctor cannot see you until Monday;  so take it.

Well, little did you know, that Monday is exactly 15 days after your car accident.  You go to get checked out, and your doctor is worried and decides to order an MRI to rule out serious problems. He also writes you a prescription and that same night, you get the MRI done.  The report comes back in a few days and there are two cervical disc herniations.  Well, your doctor at this point is thinking Orthopedics, Physical Therapy or Chiropractic care, because he knows that these things left untreated can very often get worse to the point that there is radiating pain, numbness, and tingling down your arms.  He tells you that sometimes these things require surgery.  Now you are worried.



But wait!  At least you were responsible enough to pay your auto insurance, which is mandatory in Florida.  You have always been a responsible person and actually you have been paying for years and never missed a payment and never even filed a claim.  By the way, just to let you all know, PIP insurance is primary in Florida, meaning that if you decide to use your health insurance, your health insurance company will deny your claim because your injury is auto accident related.  But, not to worry, you have GEICO.  Or was it Allstate?  Or Progressive....   Hmmm.  It doesn't matter anyway, which insurance company you have.

Do you know why?

Because your Governer, Mr. Rick Scott, created a law that states that you must initiate treatment within the first 14 days and you waited 15 days.  You are now completely out of luck.  You paid for your coverage and now your wonderful elected officials created a new way for your insurance company to deny your claim.   No coverage for you.  Your insurance company gets off the hook and they get to keep the money you paid them.  They don't have to pay your doctor bills.  And guess what?  Its a state law!

Do Not Wait.  If you have been involved in a car accident in Miramar or a car accident in Pembroke Pines FL, You should get treatment immediately.  You can call me personally, Dr. Alan Himmel.  I answer the phone myself.  954-659-8600 or 305-979-5549

You can also check out my Website, www.MiramarChiropractor.com